Individual
PETER JOSEPH STANLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1612 GUNBARREL RD STE 102, CHATTANOOGA, TN 37421-4135
(423) 954-9511
(423) 954-9912
Mailing address
1612 GUNBARREL RD STE 102, CHATTANOOGA, TN 37421-4135
(423) 954-9511
(423) 954-9912
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
4126
AR
390200000X
Student in an Organized Health Care Education/Training Program
30403
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
215452608
—
AR
Enumeration date
02/24/2014
Last updated
03/21/2022
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